Provider Demographics
NPI:1598015927
Name:SULLIVAN, MEGHAN CAMPBELL (MS LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:CAMPBELL
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MS LPC-MHSP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6350 W ANDREW JOHNSON HWY
Mailing Address - Street 2:DEPARTMENT 100
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8605
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:2544 DALTON PIKE SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323-7157
Practice Address - Country:US
Practice Address - Phone:423-728-6422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional